Case Acceptance Part 3

September 2008

Welcome to part three of 100% case acceptance. If you have not read the first 2 installments be sure and give us a call. This is a complete system that requires full understanding of every step. Remember: Your systems are precisely designed to give you the results you are getting. If you are not growing, you are not giving patients what they want. Patients vote with their feet, so let’s get them to vote to stay.

Today we are going to discuss the case acceptance system we use in our office. The only reason your patients should not be saying yes and completing treatment is money (we’ve included my payment option sheet at the end of this article).

Just like many of you, I was taught to do a formal, very thorough New Patient “Experience”, a real 5-star production. Following this you should have the patient and the significant other return to hear an hour long talk on the benefits of comprehensive dentistry. A fee that reflects the “quality” of the “experience” is charged ($250-$500). Free exams and complimentary second opinions are unethical. And like many of you, I found out that this system of multiple visits is death to a practice. This is a sure way to give the patient exactly what they do not want. Bottom line: The highest case acceptance occurs with no formal case presentation. About 12 years ago, I was fortunate to stumble upon a video produced by Gordon Christensen at CRA. The “Auxiliary Oriented Diagnostic Appointment” changed my life. For the first time, I saw a system that took into consideration the wants and needs of the patient. An exam followed by a same day case presentation that was non confrontational, caring, and compassionate. It took into consideration what the patient wanted and told them what they needed. It let the patient meet you, find out what was wrong, and decide for themselves what they wanted to do. And the best part is that the actual case presentation only took minutes and the fact finding and bonding was delegated to the staff. It’s a can’t miss, works every time, like shooting fish in a barrel with a bazooka system.

With time we have modified the system to work better, and adapted it to the changing needs of our patients. It is a true “consumer driven system”. We tell the patient what they need and happily give them what they want. As a result — we never loose a patient. It is always a balanced, no contest, never be perceived as selling way to hit a home run. Here are the steps.

1. THE PERMISSION STATEMENT: This was taken from Zig Zigler’s book, Closing the Sale. The script goes something like this: “Mrs. Jones, I feel like my job is to show you the finest dentistry I can provide. Your job is to decide whether you want to do some, all or none of the dentistry we propose. In other words, we want you to decide how quickly you get your mouth healthy.” This first part of the permission statement levels the playing field. It creates a non-confrontational setting for showing the patients what’s going on in their mouths. It is almost like saying this changes their body language from defensive to open. If you’re a Star Trek fan, we just got them to lower their cloaking and photon torpedo shields. Remember we are selling solutions to problems and good feelings. Buying is an emotional decision not a logical one. More education will not sell your dentistry. You are just trying to justify your fees. They want something that looks good, feels good, and lasts a long time. The next and most important step is to ask: “How do you feel about this?” You can’t say: “Is that OK” or any variation. It is ONLY “How do you feel about this?” This statement and only this statement will have the patient respond in a thoughtful manner. It keeps the shields down. It portrays you as a caring friend who, with them, are co-diagnosing their problems.

2. INSURANCE: This comes from Walter Hailey’s Boot Kamp. This is the script. “Mrs. Jones, I see you have dental insurance. I’m not sure whether you have “good” insurance” or “bad insurance”, but if we find something that your insurance does not cover or does not cover all of, what would you like to do?” This little statement will eliminate the confrontation on only doing what the insurance will pay. Address the choking points ahead of time and you will eliminate most resistance. The phrase “I don’t know if you have good insurance or bad insurance” plants the seed. For the first time the patient is beginning to look at insurance in a different light. They always think that all insurance is good. This opens a nonconfrontational discussion into the limits of dental benefits. At the same time, asking the patient what they want to do encourages them to answer “I want you to tell me what is wrong and let me decide what I want to do”. This allows the patient to continue to feel “in control”. For the non-assertive hygienist or doctor it removes the barriers to presenting ideal treatment. To the assertive doctor, it helps him/her step away from the doctor turned time share salesman and become a caring health care professional — someone concerned about the welfare, and budget, of the patient.

3. DIAGNOSIS AND COMPREHENSIVE EXAM: Every exam should include: FMX, Pano, oral cancer screening, a co-diagnosing camera tour of the patients mouth, full mouth probing and charting, and time to ask questions and be given answers by a staff person along with accompanying literature to satisfy every personality type. The key to this exam is that the patient must understand, verbalize, and feel that it is WORSE THAN THEY THOUGHT. In the process of the hygienist and their auxiliary staff triaging the patient (It is illegal for a staff member to diagnose. It is not illegal for them to record what they see and help the patient to see and understand the problems. This is called patient education. They are giving the patient options on what could be done if the doctor agrees. They are assessing the patients dental IQ and their budget.) Patients feel more at ease asking a staff member questions than asking a doctor. If this is done correctly, the doctor will not need to spend time doing it later.

4. CASE PRESENTATION: This should only take 2-4 minutes. Remember that your staff members have gone over problems, used the camera, answered all the questions, and provided literature to further confirm treatment options. When I walk into the room the hygienist opens her mouth first. She tells me what she and Mrs. Jones have found and discussed, while I look at the photos on the monitor, look at the treatment plan already filled in on the chart, and knowingly nod, grunt, and just look plain studious. I them re-tell the patient what is wrong, what caused it, and what will happen if it is not fixed. I take a moment on each trouble area to tell them what I would recommend (It’s real easy because the hygienist writes it down for me).

5. I CLOSE with: Mrs. Jones, what would you like to do? If done correctly over 90% of your patients will say yes. The only thing holding them back will be money.

The next installment will show you how to close the last 10%. I will also show you how you use our system and do the wrong thing. Don’t leave any thing out, keep your monitors, and give us a call and let me know how well you are doing.